9.2.3.10: Sanitation Policies and Procedures

The child care facility should have written sanitation policies and procedures for the following items:

1. Maintaining equipment used for hand hygiene, toilet use, and toilet learning/training in a sanitary condition;
2. Maintaining diaper changing areas and equipment in a sanitary condition;
3. Maintaining toys in a sanitary condition;
4. Managing animals in a safe and sanitary manner;
5. Practicing proper handwashing and diapering procedures (the facility should display proper handwashing instruction signs conspicuously);
6. Practicing proper personal hygiene of caregivers/teachers and children;
7. Practicing environmental sanitation policies and procedures, such as sanitary disposal of soiled diapers;
8. Maintaining sanitation for food preparation and food service.

RATIONALE

Many infectious diseases can be prevented through appropriate hygiene and sanitation practices. Bacterial cultures of environmental surfaces in facilities, which are used to gauge the adequacy of sanitation and hygiene practices, have demonstrated evidence of fecal contamination. Contamination of hands, toys, and other equipment in the room has appeared to play a role in the transmission of diseases in child care settings (1). Regular and thorough cleaning of toys, equipment, and rooms helps to prevent transmission of illness (1).

Animals can be a source of illness for people, and people may be a source of illness for animals (1).

The steps involved in effective handwashing (to reduce the amount of bacterial contamination) can be easily forgotten. Posted signs provide frequent reminders to staff and orientation for new staff. Education of caregivers/teachers regarding handwashing, cleaning, and other sanitation procedures can reduce the occurrence of illness in the group of children with whom they work (2).

Illnesses may be spread by way of:

1. Human waste (such as urine and feces);
2. Body fluids (such as saliva, nasal discharge, eye discharge, open skin sores, and blood);
3. Direct skin-to-skin contact;
4. Touching a contaminated object;
5. The air (by droplets that result from sneezes and coughs).

Since many infected people carry communicable diseases without symptoms, and many are contagious before they experience a symptom, caregivers/teachers need to protect themselves and the children they serve by carrying out, on a routine basis, standard precautions and sanitation procedures that approach every potential illness-spreading condition in the same way.

Handling food in a safe and careful manner prevents the spread of bacteria, viruses, and fungi. Outbreaks of foodborne illness have occurred in many settings, including child care facilities.

COMMENTS

State health department rules and regulations may also guide the child care provider.

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

3.2.1.1 Type of Diapers Worn
3.2.1.2 Handling Cloth Diapers
3.2.1.3 Checking For the Need to Change Diapers
3.2.1.4 Diaper Changing Procedure
3.2.1.5 Procedure for Changing Children’s Soiled Underwear, Disposable Training Pants and Clothing
3.2.2.1 Situations that Require Hand Hygiene
3.2.2.2 Handwashing Procedure
3.2.2.3 Assisting Children with Hand Hygiene
3.2.2.4 Training and Monitoring for Hand Hygiene
3.2.2.5 Hand Sanitizers
3.3.0.2 Cleaning and Sanitizing Toys
3.3.0.3 Cleaning and Sanitizing Objects Intended for the Mouth
3.4.2.1 Animals that Might Have Contact with Children and Adults
3.4.2.2 Prohibited Animals
3.4.2.3 Care for Animals
4.8.0.1 Food Preparation Area
4.8.0.2 Design of Food Service Equipment
4.8.0.3 Maintenance of Food Service Surfaces and Equipment
4.8.0.4 Food Preparation Sinks
4.8.0.5 Handwashing Sink Separate from Food Zones
4.8.0.6 Maintaining Safe Food Temperatures
4.8.0.7 Ventilation Over Cooking Surfaces
4.8.0.8 Microwave Ovens
4.9.0.1 Compliance with U.S. Food and Drug Administration Food Sanitation Standards, State and Local Rules
4.9.0.2 Staff Restricted from Food Preparation and Handling
4.9.0.3 Precautions for a Safe Food Supply
4.9.0.4 Leftovers
4.9.0.5 Preparation for and Storage of Food in the Refrigerator
4.9.0.6 Storage of Foods Not Requiring Refrigeration
4.9.0.7 Storage of Dry Bulk Foods
4.9.0.9 Cleaning Food Areas and Equipment
4.9.0.10 Cutting Boards
4.9.0.11 Dishwashing in Centers
4.9.0.12 Dishwashing in Small and Large Family Child Care Homes
4.9.0.13 Method for Washing Dishes by Hand
5.4.1.1 General Requirements for Toilet and Handwashing Areas
5.4.1.2 Location of Toilets and Privacy Issues
5.4.1.3 Ability to Open Toilet Room Doors
5.4.1.4 Preventing Entry to Toilet Rooms by Infants and Toddlers
5.4.1.5 Chemical Toilets
5.4.1.6 Ratios of Toilets, Urinals, and Hand Sinks to Children
5.4.1.7 Toilet Learning and Training Equipment
5.4.1.8 Cleaning and Disinfecting Toileting Equipment
5.4.1.9 Waste Receptacles in the Child Care Facility and in Child Care Facility Toilet Room(s)
5.4.1.10 Handwashing Sinks
5.4.1.11 Prohibited Uses of Handwashing Sinks
5.4.1.12 Mop Sinks
5.4.2.1 Diaper Changing Tables
5.4.2.2 Handwashing Sinks for Diaper Changing Areas in Centers
5.4.2.3 Handwashing Sinks for Diaper Changing Areas in Homes
5.4.2.4 Use, Location, and Setup of Diaper Changing Areas
5.4.2.5 Changing Table Requirements
5.4.2.6 Maintenance of Changing Tables
5.4.3.1 Ratio and Location of Bathtubs and Showers
5.4.3.2 Safety of Bathtubs and Showers
5.7.0.6 Storage Area Maintenance and Ventilation
5.7.0.7 Structure Maintenance
5.7.0.8 Electrical Fixtures and Outlets Maintenance
5.7.0.9 Plumbing and Gas Maintenance
5.7.0.10 Cleaning of Humidifiers and Related Equipment
Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting

REFERENCES

1. Chin, J., ed. 2000. Control of communicable diseases manual. Washington, DC: American Public Health Association.
2. Kotch, J., P. Isbell, D. J. Weber, et al. 2007. Hand-washing and diapering equipment reduces disease among children in out-of-home child care centers. Pediatrics 120:e29-36.